Chapter 27: Vision Services

EyeMed administers all routine exams to determine if corrective lenses are required. It also dispenses hardware such as frames, lenses, and contact lenses based on the member's benefit. EyeMed is responsible for the provider network including contracting, credentialing, claims processing and payment, routine vision grievances, and claims appeals.*


*Exception: Medicare grievances and claims appeals are managed by EmblemHealth.

There are no exempt members. EyeMed is the routine vision provider for all EmblemHealth members who have a routine vision care benefit, including our ASO members.

To determine if a member has routine vision coverage:

Participating EyeMed providers can log on to eyemed.com or call EyeMed to obtain member eligibility and benefit information.

Members must use an in-network EyeMed provider to get covered benefits for a routine exam. See the Directory chapter for EyeMed Customer Service contact information. 

If you are a vision service provider and interested in joining EyeMed, visit this site or call EyeMed's provider service department at 800-521-3605.

See the chart for routine vision exam CPT codes, materials HCPCS, and diagnosis codes that should be billed to EyeMed. Claims submitted to EmblemHealth will be denied.

Our Call Center is currently experiencing extremely high volume and longer wait times. For questions related to COVID-19, visit our COVID-19 FAQs